Sagar Dutt

Taking illness personally

Surrey boy part of clinical trial that targets cancer treatment to individuals’ unique genetic make-up.

Sagar Dutt has been on television twice before.

Once during a school strike that cancelled a sports day and once during a track meet.

This Thursday (Feb. 23) at 8 p.m., Dutt, 12, a will be featured on David Suzuki’s The Nature of Things on CBC for a cancer story.

The Grade 7 student at Surrey’s Janice Churchill Elementary is part of a clinical trial at the BC Cancer Agency with some promising results that caught the eyes of producers.

Speaking to The Leader a few days before the airing of the documentary feature Cracking Cancer, the young man gets down to business about his condition.

“It’s called neurofibromatosis. It’s Type 1, non-cancerous,” he explains. “Since I was born, one leg (the left one) was bigger than the other. (It) kept on growing faster.”

The condition sees benign tumours in his hip keep growing.

Photo: Sagar Dutt filmed by a CBC cameraman in a pool.

Throughout his life, he’s had four surgeries to try to slow down the growth. The effects of the condition and the surgical treatments have left him with periodic pain (the tumours are wrapped around nerves) and fatigue, as well as a mild limp.

“If I’m doing any work, I have to stop and rest a little bit,” Dutt says.

Recently, things changed for him.

In late 2015, during an evaluation at B.C. Children’s Hospital, Dutt learned about Personalized OncoGenomics, or POG, for the first time.

With no non-surgical options for his condition, he signed on, and for the first time, is now taking medicine that seems to be keeping his tumor growth in check.

POG aims to treat cancers in a radical new way – not according to where they originate in the body, but as a disease of genetic mutations specific to each individual.

Non-surgical cancer treatments are usually chosen based on what has been previously given to other people with the same type of cancer.

That doesn’t work with everyone, so using DNA analysis, POG aims to customize and personalize the drug to control the cancer.

POG compares the patient’s normal DNA (each cell’s complete set of instructions) to the DNA of their tumours. It also compares the RNA (important molecules needed for gene regulation) of the tumours to reference RNA.

POG then searches for mutations that might be implicated in that person’s cancer. If the mutation or its cause can be isolated, researchers can search for a drug that might block the cancer’s growth.

The drug Dutt is taking for his leg tumours is Irbesartan, which is regularly prescribed for high blood pressure.

That makes him a bit of an outlier in the program, says Dr. Janessa Laskin (left), a medical oncologist at the BC Cancer Agency in Vancouver and the clinical lead at POG, which takes place at the agency’s Genome Sciences Centre.

She says that while a few anecdotal results of the clinical trial have led to cancer patients being treated with non-cancer drugs such as those for high blood pressure or diabetes, the vast majority of the intervention is still with cancer drugs.

The difference, she says, is the program’s re-purposing – or off-label use – of drugs based on specific biological profiling, using a vast database of drugs that are cross-referenced with the work of the 300 staff at the centre who work on sampling, processing and analysis.

Super-computers are involved, she adds.

“Information from POG is not used to avoid conventional cancer treatments. The hope is to use those treatments more strategically.”

There have been both successes and failures in the clinical trial.

Laskin adds she’s an optimist, and that while POG is not a cure, it does give hope in making cancer – in its many forms – a treatable chronic condition.

When POG launched in 2012, there were 30 cancer patients in the trial. Initial results were so promising that two years later, they expanded to take in 300 people with incurable cancer. By the end of 2016, they had enrolled 750. The newest aim is for 5,000 patients.

The POG process, from biopsy to completion of genome analysis, takes about three months. In the past five years, the price tag for individual genome sequencing has come down from $250,000 to about $20,000.

Laskin notes that the first human genome sequencing was completed in 2003. Currently only B.C. residents can enrol in the trial, but POG is branching out to national and international collaborations.

“We share all genomic data with researchers around the world, because that’s the way we’re going to be able to learn from each other.

For a preview of The Nature of Things presentation of Cracking Cancer, click here.

Cancer statistics:

• Cancer is the leading cause of death in Canada and is responsible for 30 per cent of all deaths.

• Two out of five Canadians (45 per cent of men and 42 per cent of women) are expected to develop cancer in their lifetimes.

• One out of four Canadians (29 per cent of men and 24 per cent of women) are expected to die from cancer.

• New Canadian cancer cases are expected to increase 40 per cent over the next 15 years.

– Source: BC Cancer Agency

Surrey North Delta Leader

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